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| Surgery: Is it really indicated? | ||||
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A statement mentions that the surgery department lacks equipments and infrastructure. What type of equipment do you need? If you audit existing surgeries, you will discover that most of them are not required, and there has been wrong clinical diagnosis. A diagnosis of appendicitis: on operation, no findings of appendicitis. A diagnosis of cholecystitis or cholelithiasis: on operation, no findings of cholecystitis or cholelithiasis. A medical doctor is required to make correct clinical diagnoses. A surgeon is basically a medical doctor. They ask for number of unwanted investigations but after that they still cannot reach a correct diagnosis and treatment. | ||||
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Q: Who is a surgeon? A: A surgeon is a medical doctor with additional training in specific medical procedures. Getting the title of surgeon does not mean he or she is a competent medical doctor. Not all surgeons can perform all medical procedures. Not all medical doctors can perform all medical procedures. Making an eight-inch incision and closing in three layers does not prove you are a surgeon or a medical doctor. Doing a burr hole and closing does not prove you are a surgeon. This is a medical or surgical procedure that can be taught in a few weeks. Doing medical or surgical procedures does not prove you are a competent medical doctor. The ability to reach to a correct diagnosis and provide treatment is a requirement of all medical doctors while maintaining good character and good behavior. | ||||
| What type of suggestions should a medical doctor (MD) forward to improve training programs in health care and medical education? | ||||
| What do you have to do in case you need to be a surgeon? | ||||
| What questions should a medical doctor or surgeon ask an anesthetist? | ||||
| Surgery Patients | ||||
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Can you enumerate various medical procedures? Can you enumerate various surgical skills? | ||||
| Why do you want to do surgery? | ||||
| Surgical Instruments | ||||
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What are the different types of surgery? What are the surgical specialties? | ||||
Neurosurgery
Q: What is a neurosurgeon? Q: Who sees a neurosurgeon? Q: What might neurological care involve? Q: What areas of care are available? Q: Who is a neurosurgeon? Q: What does neuroscience care involve? Q: Where is the neuroscience patient cared for?
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Cardiothoracic surgery | ||||
| Oral and maxillofacial surgery | ||||
| Otolayrngology | ||||
| Eye Surgery | ||||
| OB/GYN Surgery | ||||
| Paediatric surgery | ||||
| Plastic Surgery | ||||
| Orthopaedic surgery | ||||
| Urology | ||||
General surgery
Do all cases of cholecystitis or gallstones need surgery? Dr. Qureshi's technique Q: What are the advantages of laparoscopy? A: It is less invasive, cost effective, results in fewer infections, and shorter hospital stay. Also, early return to work, minimal postoperative complications, and cosmetic advantages, too. Can appendicitis be managed with endoscopic/Laparoscopy removal without general anesthesia? Q: What does the surgeon use to close the wound? Q: What is the difference between sutures, staples and Steri-Strips? Q: Do all sutures dissolve? Q: Is it painful to have sutures and staples removed? Q: How is the wound bandaged? Q: How should I care for my wound? Q: Is it normal for the wound to itch? Q: How do I take care of my wound at home? Q: When can I take a shower? Q: Does it take a long time for the wound to heal? Do you have a question? Can you make me wiser? How? Can you make us wiser? How? Would you like to add anything? Who among you has done laparoscopic surgery? How many surgeries have you done so far? What was the diagnosis? What were the indications? What were the results? Were there any post- procedure complications? What were these complications? What is been done to prevent these complications? Who is the manufacturer of the equipment? What is the material of the existing equipment? What is been done to enhance the efficiency of a laparoscopy? What is been done to train others? Who has the responsibility to fund this research and development? | ||||
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* Alimentary tract: Esophagus, Stomach, Small bowel, Large bowel, Rectum * Abdomen and its contents: Diaphragm, Liver, Gallbladder and Bile duct, Pancreas, Spleen * Breast, skin, and soft tissue: Benign and malignant disease * Endocrine: Thyroid and Parathyroid glands, the Pancreas and Adrenal glands * Surgical oncology: Coordinated care of the cancer patient * Vascular system: Arteries and Veins, excluding the vessels in the brain, heart, and lungs * Minimally invasive surgery: Should be up to date with recent advances in laparoscopic and endoscopic surgery. * Comprehensive management of trauma: The responsibility for all phases of care of the injured patient General Surgery staff perform a variety of procedures including, but not limited, to: * Appendectomy * Cholecystectomy * Laparoscopic and Open Hernia Repair
o Umbilical o Incisional o Hiatal * Esophagogastric Fundoplasty * CAPP Catheter Placement * Lipoma Excision * Laparoscopic Surgery
o Peritoneal carcinomatosis o Melanomas o Splenectomy o Cholecystectomy o Gastric Bypass o Exploratory Surgery o Liver resection o Radio Frequency Ablation (RFA) for liver tumors o Whipple o Nissen o Retroperitoneal lymph node excision | ||||
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* Abdominal Perineal Resection * Abdominal Surgery * Adrenal Surgery * Adrenalectomy * Advanced Laparoscopic Surgery * Appendectomy * Biliary Surgery * Breast Biopsy * Breast Diagnostics * Colectomy * Colon Surgery * Complex Abdominal Hernia Repair * Endocrine Surgery - Thyroid And Parathyroid * Fecal Diversion * Gastrectomy * Gastrointestinal Surgery * Hernia Surgery * Laparoscopic Adrenalectomy * Laparoscopic Antireflux Surgery * Laparoscopic Cholecystectomy * Laparoscopic Hernia Surgery * Laparoscopic Incisional Hernia Repair * Laparoscopic Inguinal Hernia Repair * Laparoscopic Lymph Node Biopsy * Laparoscopic Proctosigmoidectomy * Laparoscopic Solid Organ Surgery * Laparoscopic Splenectomy * Laparoscopic Surgery * Laparoscopic Surgery for Digestive Diseases * Laparoscopic Ventriculoperitoneal Shunt Placement * Laparoscopy * Liver Biopsy * Minimally Invasive Surgery for Achalasia * Nipple & Skin Sparing Mastectomy * Nissen Fundoplication * Office Ultrasound Guided Biopsy * Open Inguinal And Abdominal Hernia Repair * Pancreatic Surgery * Parathyroid Surgery * Sentinel Lymph Node Biopsy * Sentinel Lymph Node Procedures * Septoplasty * Splenectomy * Stereotactic Breast Biopsy * Surgery For Breast Cancer * Surgery for Diseases Of The Breast * Surgical Drains * Thyroidectomy * Tracheostomy Specialty in Diseases and Conditions * Abdominal Pain * Achalasia * Adrenocortical Carcinoma * Anal Abscesses * Anal Fissures * Appendicitis * Benign Soft Tissue Tumors * Breast Cancer * Breast Disease * Cancer * Carcinoid Syndrome * Colon Diseases * Colorectal Cancer * Cysts * Diverticulosis * Gallbladder Cancer * Gallbladder Disease * Gallstones * Gastritis * Gastroesophageal Reflux (GERD) * Goiter * Hernias * Hiatal Hernia * Inguinal Hernia * Intra-abdominal Cancer/Tumor * Intussusception * Large Intestine Cancer * Melanoma * Nipple Discharge * Pancreatic Cancer * Pancreatic Disease * Parathyroid Cancer * Parathyroid Disease and Calcium Disorders * Polyps * Recurrent Breast Cancer * Small Intestine Cancer * Stomach Cancer * Temporal Arteritis * Thyroid Cancer * Thyroid Disease * Thyroid Nodule | ||||
| Biopsy | ||||
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What questions should be answered in case surgery is recommended? What are the possible complications during and after surgery? Who should be held responsible if any complications during or after surgery? What type of surgery is recommended? How is this type of surgery done? How long will the surgery last? Who will do the surgery? Who will give the anesthesia? What type of anesthesia will be given? What drugs will be utilized to give anesthesia? What are the possible complications of this type of anesthesia? How many similar operations has the medical doctor or surgeon done? How many patients developed complications during or after surgery? What were the reported complications during and after surgery? What will happen if surgery is not done? | ||||
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How do you define surgery? Should the term surgery be replaced with medical procedure? | ||||
| Preoperative instructions | ||||
| Inside operating room | ||||
| Operative notes | ||||
| Postoperative complications | ||||
| Postoperative follow-up | ||||
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What is the minimum number of copies you should order? One million. Who may order this book? Department of Education, libraries, universities, schools, booksellers, others. Who may procure these resources? Why should you procure them only from me/us? The product and service is of highest quality, researched, perused, edited, copyrighted, sole source, and indispensable. |
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Preparing for Surgery
How do I schedule surgery? What tests do I need before surgery? Where should I get my pre-operative tests? What are the general instructions I should follow before my surgery? Where should I go the day of my surgery? After Surgery Where do I recover after outpatient surgery? Where do I recover after inpatient surgery? What are the general instructions I should follow after surgery? How can I contact my surgeon with questions after surgery? What follow up appointments are necessary? Anal Surgery What are the potential risks and complications of anal surgery? What preparation is required before anal surgery? Is hospitalization required for anal surgery? What can I expect in terms of recovery from anal surgery? What are the post-operative instructions that I should follow? Appendectomy What are the potential risks and complications of an appendectomy? What preparation is required before an appendectomy? Is hospitalization required after an appendectomy? What can I expect in terms of recovery from an appendectomy? What are the post-operative instructions that I should follow? Breast Surgery What are the potential risks and complications of breast surgery? What preparation is required before breast surgery? Is hospitalization required for breast surgery? What can I expect in terms of recovery from breast surgery? What are the post-operative instructions that I should follow? Colon Surgery What are the potential risks and complications of colon surgery? What preparation is required before colon surgery? How long will I have to stay in the hospital after surgery? What can I expect in terms of recovery from colon surgery? What are the post-operative instructions that I should follow? Gallbladder Surgery What are the potential risks and complications of gallbladder surgery? What preparation is required before gallbladder surgery? Is hospitalization required for gallbladder surgery? What can I expect in terms of recovery from gallbladder surgery? What are the post-operative instructions that I should follow? Inguinal (Groin) Hernia Repair What are the potential risks and complications of inguinal hernia repair? What preparation is required before an inguinal hernia repair? Is hospitalization required after an inguinal hernia repair? What can I expect in terms of recovery from an inguinal hernia repair? What are the post-operative instructions that I should follow? Thyroid or Parathyroid Surgery What are the potential risks and complications of thyroid or parathyroid surgery? What preparation is required before thyroid or parathyroid surgery? Is hospitalization required for thyroid or parathyroid surgery? What can I expect in terms of recovery from thyroid or parathyroid surgery? What are the post-operative instructions that I should follow? Ventral Hernia Repair What are the potential risks and complications of ventral hernia repair? What preparation is required before a ventral hernia repair? Is hospitalization required after a ventral hernia repair? What can I expect in terms of recovery from a ventral hernia repair? What are the post-operative instructions that I should follow? Preparing for Surgery How do I schedule surgery? What tests do I need before surgery? Blood tests such as complete blood count, electrolytes, liver function tests, and PT, PTT may be necessary, depending on your age and medications. An EKG within six months of surgery is necessary if you are older than 50. If you have an abnormal EKG or history of heart disease, you may need a stress test or echocardiogram. Your surgeon will discuss this with you. A chest X-ray may be necessary if you have a history of lung disease or smoking. Where should I get my pre-operative tests? You should be able to obtain your pre-op testing at your primary doctor’s office. If not, the tests may be ordered by the surgeon and performed at the hospital. What are the general instructions I should follow before my surgery? You will need to stop taking any medication that will thin the blood, such as Plavix, Ecotrin, Ticlid, Persantine, etc. This includes Aspirin, Motrin, Ibuprofen, or any other anti-inflammatory medications except Tylenol. This also includes St. John’s Wort, Ginko, and other herbal medicines. You should stop these medications 10 days prior to surgery. If you take the blood thinner Coumadin, special arrangements will be made. You will stop this 3 or 4 days prior to surgery. If you are having colon surgery, you will need to cleanse your bowels starting the day before. We will give you separate instructions for this. You should take NO FOOD or LIQUIDS by mouth after midnight the night before surgery, if you are to receive any anesthesia other than local. You may take your high blood pressure medication with a sip of water the morning of surgery. If you are a diabetic, please call your surgeon to find out how much insulin or medication to take the day of surgery. You should expect a call from the Hospital the day before surgery to confirm the time of the operation, as the schedule will occasionally change. Where should I go the day of my surgery? After Surgery Where do I recover after outpatient surgery? After the procedure you will go to the recovery room to wake up. You will return to same day surgery, where you will get some liquids to drink. You will be discharged when they feel you are stable, usually in 2-3 hours. If you will be receiving any IV sedation or anesthesia, you will need someone to give you a ride home. Where do I recover after inpatient surgery? For inpatient surgery you will go to the recovery room for up to one hour after the surgery, and then you will be transferred to a hospital room. Your surgeon will talk to your family and friends in the waiting room after the procedure. They will not be able to visit you in the recovery room. What are the general instructions I should follow after surgery? A separate set of post-operative instructions will be given to you upon discharge. Many of these are also available on our Patient Forms page. How can I contact my surgeon with questions after surgery? If you have any questions after discharge, or if you think there is a problem, call _______ number. During the day, ______ will take your call and contact a doctor, who will call you back. After hours, one of the physicians is always on call and can be paged through our office voice mail system, ______. What follow up appointments are necessary? Patients generally come in for one or two follow up visits. The first one is 7-10 days after the surgery unless otherwise specified. Anal Surgery What are the potential risks and complications of anal surgery? Some possible complications of this procedure include: Infection, possibly requiring another operation to drain Bleeding requiring re-operation Very rare complications include: Injury to the anal sphincter possibly causing incontinence Adverse reaction to the anesthesia Any complication can lead to additional procedures, re-operation and prolonged recovery What preparation is required before anal surgery? You may eat solid food for lunch the day before the procedure. Take only clear liquids after lunch the day before the procedure. This includes soda, juice, Jell-O, broth, and Italian ice. You should also take one fleets enema at 8 PM the night before the procedure and one at 7 AM the day of the procedure. This may be purchased over the counter. If you have any further questions, do not hesitate to call at any time, 847-433-1060. Is hospitalization required for anal surgery? No, hospitalization is not usually necessary. What can I expect in terms of recovery from anal surgery? Every case is different, but the following are averages: Narcotic pain medicine is necessary for 3-5 days. You should not lift anything heavier than 20lbs for 7 days. You may resume aerobic exercise in 7 days. You will probably need 5-7 days off of work. What are the post-operative instructions that I should follow? See the following document for detailed instructions about diet, wound care, activities, medication, your follow-up appointment, and emergency instructions: Anal Surgery: Post-Op Instructions Appendectomy What are the potential risks and complications of an appendectomy? Some possible complications of this procedure include: Infection of the skin Leakage from the bowel causing fistula or abscess, possibly requiring colostomy Prolonged intestinal ileus (paralysis of intestinal function) Very rare complications include: Bleeding requiring transfusion or re-operation Injury to surrounding structures, including ureter and small intestine Adverse reaction to the anesthesia Blood clots and pulmonary embolism Any complication can lead to additional procedures, re-operation and prolonged recovery. What preparation is required before an appendectomy? No preparation is necessary. Is hospitalization required after an appendectomy? Yes, depending on the extent of infection. What can I expect in terms of recovery from an appendectomy? Every case is different, but the following are averages: Narcotic pain medicine is necessary for 3-5 days after discharge. You should not lift anything heavier than 10lbs for 30 days. You may resume aerobic exercise in 14 - 21 days. You will probably need 2 - 4 weeks off of work. What are the post-operative instructions that I should follow? See the following document for detailed instructions about diet, wound care, activities, medication, your follow-up appointment, and emergency instructions: Appendectomy: Post-Op Instructions pdf document Adobe Reader Breast Surgery What are the potential risks and complications of breast surgery? Some possible complications of this procedure include: Bleeding and hematoma formation, occasionally requiring re-operation for drainage Infection, possibly requiring drainage Seroma formation, possibly requiring aspiration or drainage Recurrence of the Cancer False negative sentinel node biopsy Numbness of the skin under the arm Rare complications include: Nerve injury causing shoulder weakness Lymphedema of arm Adverse reaction to the anesthesia Any complication can lead to additional procedures, re-operation and prolonged recovery. What preparation is required before breast surgery? Preoperative injection of radioactive tracer is required for a sentinel node biopsy. This is usually done the day before surgery. Is hospitalization required for breast surgery? One night of hospitalization is required for a mastectomy. Lumpectomy and axillary dissection is usually done as an outpatient procedure. What can I expect in terms of recovery from breast surgery? Every case is different, but the following are averages: Narcotic pain medicine is necessary for 5 - 7 days after discharge. You should not lift anything heavier than 10lbs for 7 days. Specific arm exercises will be given at your first post-op visit. You may resume aerobic exercise in 14 - 21 days. The recovery time varies widely depending on the extent of the procedure performed. Usually not more than a week for breast conservation surgery and two weeks for a mastectomy. What are the post-operative instructions that I should follow? See the following document for detailed instructions about diet, wound care, activities, medication, your follow-up appointment, and emergency instructions: Breast Lumpectomy/Biopsy: Post-Op Instructions pdf document Adobe Reader Colon Surgery What are the potential risks and complications of colon surgery? Some possible complications of this procedure include: Infection of the skin Leakage from the bowel causing fistula or abscess, possible requiring colostomy Prolonged intestinal ileus (paralysis of intestinal function) Pneumonia, urinary tract infection Very rare complications include: Bleeding requiring transfusion or re-operation Injury to surrounding structures, including ureter, spleen, and small intestine Adverse reaction to the anesthesia Blood clots and pulmonary embolism Any complication can lead to additional procedures, re-operation and prolonged recovery What preparation is required before colon surgery? You may eat solid food for dinner two days before the day of surgery. Take only clear liquids the day before surgery. This includes soda, juice, Jell-O, broth, and Italian ice. You will be prescribed Fleets Phosphosoda as a laxative. Take 1 ½ ounces by mouth, followed by two 8 oz. glasses of water or ginger ale at 8 AM and again at noon the day before surgery. You will also be prescribed two oral antibiotics, Neomycin and Flagyl, to help eradicate the bacteria in the colon. Take them at 1 PM, 3 PM, and 11 PM the day before surgery. If you do not have clear, watery diarrhea by the end of the day before surgery, call our office, you may need enemas to further cleanse your colon. If you experience cramping or vomiting, please call to let us know, we may need to alter the preparation. If you have any further questions, do not hesitate to call at any time, ______. How long will I have to stay in the hospital after surgery? The average hospital stay is from 3 to 7 days. What can I expect in terms of recovery from colon surgery? Every case is different, but the following are averages: Narcotic pain medicine is necessary for 7 - 10 days after discharge. You should not lift anything heavier than 10 lbs for 30 days. You may resume aerobic exercise in 14 - 21 days. You will probably need 2 - 4 weeks off of work. What are the post-operative instructions that I should follow? See the following document for detailed instructions about diet, wound care, activities, medication, your follow-up appointment, and emergency instructions: Colon Resection: Post-Op Instructions pdf document Adobe Reader Gallbladder Surgery What are the potential risks and complications of gallbladder surgery? Some possible complications of this procedure include: Conversion to an open procedure Infection of the skin Recurrent upper abdominal pain Rare complications include: Bleeding requiring re-operation or transfusion Bile leakage requiring re-operation or drainage Infection in the abdomen, occasionally requiring drainage Injury to surrounding structures, including the intestine or bile duct Chronic fatty food intolerance or diarrhea Adverse reaction to the anesthesia Any complication can lead to additional procedures, re-operation and prolonged recovery. What preparation is required before gallbladder surgery? No preparation is necessary. Is hospitalization required for gallbladder surgery? Nearly all patients stay one night in the hospital. What can I expect in terms of recovery from gallbladder surgery? Every case is different, but the following are averages: Narcotic pain medicine is necessary for 4 - 7 days after discharge. You should not lift anything heavier than 20lbs for 21 days. You may resume aerobic exercise in 14 - 21 days. You will probably need 1 - 2 weeks off of work. What are the post-operative instructions that I should follow? See the following document for detailed instructions about diet, wound care, activities, medication, your follow-up appointment, and emergency instructions: Cholecystectomy: Post-Op Instructions pdf document Adobe Reader Inguinal (Groin) Hernia Repair What are the potential risks and complications of inguinal hernia repair? Some possible complications of this procedure include: Bleeding and bruising of the abdominal wall Seroma (fluid collection under skin, occasionally requiring aspiration) Temporary nerve injury causing groin pain, or numbness Rare complications include: Recurrence of the hernia Chronic groin pain Infection of the skin or mesh Injury to surrounding structures, such as testicular vessels or vas deferens, possibly leading to the need for removal of the testicle Adverse reaction to the antibiotics or the anesthesia Any complication can lead to additional procedures, re-operation and prolonged recovery. What preparation is required before an inguinal hernia repair? No preparation is necessary. Is hospitalization required after an inguinal hernia repair? No, hospitalization is not usually necessary. What can I expect in terms of recovery from an inguinal hernia repair? Every case is different, but the following are averages: Narcotic pain medicine is necessary for 1 - 2 days after discharge. You should not lift anything heavier than 10lbs for 30 days. You may resume aerobic exercise in 14 days. You will probably need 5 - 7 days off of work. What are the post-operative instructions that I should follow? See the following document for detailed instructions about diet, wound care, activities, medication, your follow-up appointment, and emergency instructions: Inguinal Hernia Repair: Post-Op Instructions pdf document Adobe Reader Thyroid or Parathyroid Surgery What are the potential risks and complications of thyroid or parathyroid surgery? Some possible complications of this procedure include: Bleeding and hematoma formation Skin infection Rare complications include: Injury to the recurrent laryngeal nerve causing hoarseness or possible vocal cord paralysis Injury to the superior laryngeal nerve affecting singing and voice Injury to the parathyroid glands causing hypocalcemia Adverse reaction to the anesthesia Any complication can lead to additional procedures, re-operation and prolonged recovery. What preparation is required before thyroid or parathyroid surgery? No preparation is necessary. Is hospitalization required for thyroid or parathyroid surgery? Usually a one night stay is necessary. What can I expect in terms of recovery from thyroid or parathyroid surgery? Every case is different, but the following are averages: Narcotic pain medicine is necessary for 2 - 5 days after discharge. You should not lift anything heavier than 10lbs for 7 days. You may resume aerobic exercise in 14 - 21 days. You will probably need 1 - 3 weeks off of work. What are the post-operative instructions that I should follow? See the following document for detailed instructions about diet, wound care, activities, medication, your follow-up appointment, and emergency instructions: Thyroid Parathyroid Surgery: Post-Op Instructions pdf document Adobe Reader Ventral Hernia Repair What are the potential risks and complications of ventral hernia repair? Some possible complications of this procedure include: Bleeding and bruising of the abdominal wall Recurrence of the hernia Seroma (fluid collection under skin, occasionally requiring aspiration) Temporary nerve injury causing abdominal pain, or numbness Rare complications include: Chronic abdominal wall pain Infection of the skin or mesh, requiring removal of the mesh Injury to intestine or surrounding structures, requiring re-operation Bowel obstruction Bleeding requiring a transfusion Adverse reaction to the antibiotics or the anesthesia Any complication can lead to additional procedures, re-operation and prolonged recovery. What preparation is required before a ventral hernia repair? No preparation is necessary. Is hospitalization required after a ventral hernia repair? Yes, patients usually stay 2 to 4 days in the hospital. What can I expect in terms of recovery from a ventral hernia repair? Every case is different, but the following are averages: Narcotic pain medicine is necessary for 7- 14 days after discharge. You should not lift anything heavier than 10 lbs for 30 - 45 days. You may resume aerobic exercise in 14 - 21 days. You will probably need 2 - 4 weeks off of work. What are the post-operative instructions that I should follow? See the following document for detailed instructions about diet, wound care, activities, medication, your follow-up appointment, and emergency instructions: Ventral or Umbilical Hernia Repair: Post-Op Instructions pdf document Adobe Reader |
| Laparoscopy |
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Swelling Hernia Scrotal Swelling Goitre Lymphadenopathy Breast lump Splenomegaly Jaundice Varicose Veins Ischaemia Nerve Injury Lymphoedema Ulcer of the face Leg Ulcer Cleft Lip & Palate Hypospadias Home Care Advice for Sutures 1. Suture Care for a normal sutured wound: 1. Keep sutured wounds completely dry for first 24 hours (4 hours for Dermabond skin glue) 2. Your surgical team will make a determination about when you can take a shower. However in most cases this will be approximately 4 to 5 days after your surgery. Avoid swimming, baths or soaking the wound until sutures are removed or Dermabond has fallen off. (Reason: water in the wound can interfere with healing) 3. Apply antibiotic ointment 3 times a day (Reason: to prevent infection and a thick scab). (Caution: don't apply any ointments or creams to Dermabond skin glue) 4. Cleanse with warm water once daily or if becomes soiled. 5. Change wound dressing when wet or soiled. Dressing no longer needed when edge of wound closed (usually 48 hours) 6. EXCEPTION: dressing needed to prevent sutures from catching on clothing. 7. For pain relief, give acetaminophen (eg Tylenol) every 4 hours OR ibuprofen every 6 hours as needed. (See Dosage table) 2. Removal Date: Guidelines for when particular sutures (stitches) should be removed: 1.Face 4-5 days 2.Neck 7 days 3.Scalp 7-10 days 4.Chest, abdomen and back 7-10 days 5.Arms and back of hands 7 days 6.Legs and top of feet 10 days 7.Palms and soles 12-14 days 8.Overlying a joint 12-14 days 3. Removal Delays: Don’t miss your appointment for removing stitches. Stitches removed late can leave unnecessary skin marks and occasionally scarring. It also makes suture removal more difficult. 4. Suture Out Early: If the sutures come out early: 1. Reinforce the wound with tape or butterfly Band-Aids until the office visit 5. Wound Protection: After removal of sutures: 1. Protect the wound from injury during the following month 2. Avoid sports that could re-injure the wound. If a sport is essential, apply tape before playing. 3. Allow the scab to fall off naturally. Do not try to remove it. 6. Call Your Doctor If... 1. Looks infected 2. Fever 3. Sutures come out early Introduction What does the surgeon use to close the wound? The different types of closures that you will hear about are sutures, staples, and Steri-Strips™. In most instances, you will have a combination of wound closure techniques. Your surgeon will decide which type of closure he will use for your surgical wound. Your surgical wound will be closed in multiple layers. In essence the surgeon will first close your muscle layer and then your skin layer. Some types of suture are used to close the muscle layer or layers first. This is common practice. What is the difference between sutures, staples and Steri-Strips? Sutures are what most people call stitches. This is when the surgeon actually uses material similar, but stronger, than thread. There are many different types of suture material available to your surgeon. Most often the physician chooses the type of suture to be used based on personal preference. Using a needle and thread the surgeon will sew your wound closed. Whether your surgeon uses sutures, staples or Steri-Strips is once again based on the surgeon's preference and his decision of how important it is to close your wound rapidly. Using the Steri-Strip™ method requires a closure with many small stitches of the layer immediately below your skin. The Steri-Strips™ (which look like tape strips) are placed across the wound to hold the skin edges together. This often takes considerable time in the operating room and may not be indicated if (1) the time of your surgery is extended, (2) you have had previous surgery in the area, (3) your healing may be compromised due to other health problems or, (4) you have any other health concerns that would not make this type of closure the best method for you. Staples are small metal clips that hold the wound closed. This method allows the surgeon to close your wound more rapidly. Your surgeon is the best judge as to the type of closure appropriate for your surgical wound. Do all sutures dissolve? There are many types of suture material, some of which are dissolvable and some are not. The type of suture used to close your wound will depend on whether your surgery is in the front or back of the spine. In many instances, a combination of closure material is used. Some of the suture material will dissolve once your wound is completely healed. You may ask your surgeon about the type of closure he plans for your wound. Is it painful to have sutures and staples removed? Removing either sutures or staples may be uncomfortable but should not be painful. Your surgeon or nurse will explain how long this will take for your particular wound. Obviously, the longer the wound the greater time it will take to remove your sutures or staples. Removal of the closure material normally ranges from one to five minutes depending on the length of the wound and the number of sutures or staples to be removed. How is the wound bandaged? Immediately after surgery your wound will be covered with sterile bandages. Normally this first bandage, often referred to as the surgical dressing, will be removed the day after surgery. The surgeon or nurse will examine your wound to be sure that it looks as expected. Depending on the type of closure you have had and your surgeon's preference, another bandage may be applied. Do not be concerned if no bandage is reapplied. Once again, your surgeon will make this determination. How should I care for my wound? There is very little care that needs to be given to your surgical wound. The most important aspect for the first 72 to 96 hours will be to keep the wound dry and clean. Your surgical wound will be assessed each day by your surgeon and nurses to be sure that it is progressing and that no signs of infection are present. They will alert you to any concerns that they have about your wound and give you specific instructions regarding your wound care. Is it normal for the wound to itch? A few days after your surgery you may notice some itching near your surgical wound. Most people say that is a sign of healing but it may also be a result of the Steri-Strips™ or other tapes that have been used. It is best to avoid itching the wound. If it becomes too much of a problem, speak with your surgeon or nurse. They may order medications by mouth or some topical cream to help make this more tolerable. How do I take care of my wound at home? When you go home from the hospital you should have someone look at your wound on a daily basis. It is normal to have some fullness in your wound after spine surgery. This is a result of swelling or hematoma. A hematoma is an accumulation of blood that has occurred during and after your wound was closed. In most cases, your body will absorb this fluid with no additional concern. If the hematoma is significant and has not begun to resolve after several days, your surgeon may want to remove the fluid by aspirating the wound. Other signs of concern will be redness or drainage from the wound. If the swelling is increasing, the wound becomes red / inflamed or you notice drainage, you should contact your surgeon or nurse for additional instructions. When can I take a shower? Your surgical team will make a determination about when you can take a shower. However in most cases this will be approximately 4 to 5 days after your surgery. Be sure to ask your surgeon or nurse about the timing of that first shower. Normally baths are discouraged for the first couple of weeks due to difficulty getting in and out of a bathtub, as well as avoiding soaking the wound in bath water. Does it take a long time for the wound to heal? Your wound will be healed within two weeks from your surgery unless there has been some reason to delay that healing. In addition people that have other medical problems such as diabetes, people who need to take daily steroids for other conditions, and those people whose immune system may be compromised, may need additional time for their wounds to completely heal. If you have questions about the time it will take for your wound to heal, discuss this with your surgeon. Is wound care different for a child? Children's wounds heal very quickly and normally without problem. Preventing your child from itching the wound or touching the wound is very important. If the child requires the use of a diaper, an additional measure to protect a surgical wound in that area is necessary. Special bandage material that forms water tight protection for the wound will be used until the wound is healed. If your questions have not been answered, we urge you to discuss your concerns with your surgeon. |